Erectile dysfunction (ED) is a common problem in aged men; however, the molecular events involved in aging ED remain unclear. To better characterize the effects of aging in the penis, we evaluated cavernosal tissue remodeling capability and the downstream activation of the intracellular signaling mediator mitogen-activated protein p42/44 kinase (p42/44 MAPK). We used male Wistar rats, which were divided in groups of 2, 6, 12, 18, and 24 months old. Penile tissues were harvested and processed for protein isolation and immunohistochemical analysis. Cavernosal viability was assessed by TUNEL assay, and proliferation was analyzed by immunohistochemical detection of proliferating cell nuclear antigen (PCNA). Immunolocalization of the activated form of p42/44 MAPK was evaluated by immunofluorescence, and changes in its phosphorylation status were quantified by western blotting. p42/44 phosphorylation profile was also assessed in situ in human young and elderly cavernosal samples. With the advancement of age, experimental cavernosal tissue remodeling was affected by an age-dependent unbalance between the rate of apoptosis and proliferation, in all erectile components. Moreover, this turnover alteration was accompanied by significant modifications in the activation profile of the downstream effector p42/44 MAPK. In the youngest corporeal samples, p42/44 was mostly activated at perivascular sites, potentially mediating cell survival/proliferation. However, in elderly experimental erectile tissue, p42/44 phosphorylation shifted to trabecular fibroblasts, indicating a potential role in extracellular matrix (ECM) production. More importantly, the same differential pattern of p42/44 activation was observed in human young and aged cavernosal fragments, suggesting a distinct function of this protein with aging. We provided evidence for the first time that with the advancement of age, there is a differential activation of p42/44 MAPK in cavernosal tissue, which may promote ECM expansion and fibrosis, therefore compromising erectile function in the elderly.
As úlceras em pé diabético (UDP) destacam-se como a complicação mais frequente que ocorre em pacientes diagnosticados com Diabetes Mellitus (DM) tipo I e II, resultando em significativa taxa de prevalência, morbimortalidade e aumento de custos associado a internações hospitalares. Entende-se que, devido à alta prevalência do pé diabético associado aos altos custos que são gerados aos sistemas de saúde, é imprescindível contribuir para a redução dessa complicação. Portanto, esse trabalho tem como objetivo geral compreender sobre o pé diabético, suas causas, complicações para poder prevenir tal agravo. Trata-se de revisão narrativa, desenvolvida com base em artigos publicados em periódicos e documentos de órgãos oficiais. Este método permite descrever o estado da arte, de modo a sintetizar o conhecimento já exposto na literatura, somado às reflexões propostas pelos autores. Tal metodologia contribui para a discussão sobre um tema e é indicada para temáticas que necessitam de maiores aprofundamentos, que embase a prática e sirva de subsídio para olhar para as tecnologias de cuidado que podem ser utilizadas pelo profissional de enfermagem na APS para prevenir o pé diabético. Os resultados abordam a epidemiologia do pé diabético e os fatores de risco, e o cuidado e prevenção do pé diabético. O presente estudo tem o intuito de beneficiar acadêmicos e profissionais acerca de um maior conhecimento sobre o pé diabético e da atuação da enfermagem na sua prevenção. Além disso, possibilitar a melhora da qualidade do atendimento preventivo de úlceras nos pés a paciente diabéticos e assim diminuindo a incidência desse grave problema de saúde.
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